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Accelerated Medical Practice Blog

A healthcare technology blog, sponsored by White Plume Technologies.


Advanced Revenue Cycle Analytics: Provider-Specific Adjustments


Coding changes made for individual providers is another helpful insight gained from Advanced Revenue Cycle Analytics.  Many revenue cycle managers intuitively know which physicians consume the most coding resources.  Physician-specific data often confirms objectively what we have known subjectively for years.  However, sometimes the results are surprising to revenue cycle staff by pointing out patterns that were not previously detected.

In the nearby table, provider-specific analytics allow revenue cycle departments to review total encounters, CPT codes, and changes for each provider.  The three highlighted providers are both high volume and have a high percentage of encounters that require changes to CPT codes.

These changes are time consuming for the revenue cycle staff because they are stopping on 50-80% of these encounters to make a coding change.  When we drilled down into deeper detail with this practice, we identified that these three physicians are all sub-specialists who have a common procedure that was not listed on their electronic superbill.  The physicians took time to free text the procedure description, and the coding staff would later add the appropriate CPT code.  This workflow was sub-optimal for both the clinical and revenue cycle staff.

White Plume worked with this practice to add the necessary procedures to the electronic superbill which reduced the number of clicks for the physician.  This change also reduced the number of manual interventions made by the revenue cycle staff.

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